Treating Aches and Pains with Centralized Referral Management

“The way it works just makes sense. The whole referral process flows so much more easily.”

Kelly Brown, Referral Coordinator

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  • 130 Providers
  • 49 clinics
  • Regional Value-Based Musculoskeletal Network
About Colorado Integrated Care Network

With 49 clinics serving the Front Range region of Colorado (which includes the cities of Denver, Colorado Springs and Boulder), Colorado Integrated Care Network provides non-surgical musculoskeletal care – including physical therapy, chiropractic care, and pain management services – with a multidisciplinary approach.

As is common with specialty healthcare clinics, the CICN clinics rely on physician referrals for their patient base. “Our referrals primarily come in from primary care physicians in the area,” says Kelly Brown, Referral Coordinator for CICN.

Effective referral management is critical for CICN. As a value-based integrated network, CICN seeks to drastically lower the average number of patient visits and total cost of care, while maintaining high patient satisfaction. As part of meeting these goals, CICN works to ensure all patient referrals are scheduled promptly and efficiently.

The Challenge

Before implementing LeadingReach, CICN did not have any centralized referral system for its clinics. Instead, the individual clinics handled referrals on their own. “We were a group of clinics that billed under the same payor contracts,” says Brown. “But beyond that, the clinics did not have any interconnectivity.”

The situation changed when CICN partnered with New West Physicians, a Denver-area healthcare group, to receive referrals from New West primary care physicians. As part of the arrangement, CICN would establish a centralized referral system to direct New West patients to the best clinic for their care. Accordingly, New West was relieved of these referral management responsibilities, while CICN now had a large referral base.

To establish its centralized referral system, CICN turned to the LeadingReach referral management platform. CICN’s CEO, Dr. Garret Rock, asked Brown to take on the role of referral coordinator. Brown had been with CICN for over 4 years at the time, primarily handling billing and administrative work.

Notably, Brown had no experience with centralized referral management, and she did not view herself as tech-savvy. “Computers tend to freak me out a little bit,” she says. “When Garret first proposed this new role to me, I was thinking ‘This is gonna take a massive spreadsheet.’ And I don’t like spreadsheets.” But this was before Brown familiarized herself with the LeadingReach platform.

We were a group of clinics that billed under the same payor contracts,” says Brown. “But beyond that, the clinics did not have any interconnectivity.”

The Solution

Brown was able to get up to speed with the LeadingReach platform fairly quickly. “The new
role was overwhelming at first, since I’d never done referral management before,” says Brown. “But right away, I was impressed with how easy Leading Reach was to use. It intuitively made sense and there was never a struggle with it.”

With LeadingReach in place, Brown now receives the incoming PCP referrals via fax. She then enters the information for each referral into the LeadingReach platform. Based on various factors, including the type of treatment needed, location, and the patient’s insurance, Brown chooses a CICN clinic to which she can send the referral. Then Brown distributes the referrals through LeadingReach, with each clinic taking care of its own referral scheduling.

“Most of the clinics will confirm the referral status through LeadingReach after I send it – accepted, viewed, scheduled, etc.” says Brown. “That saves me the trouble of a follow-up call.” Some of the CICN clinics are also using LeadingReach for their referral management. One clinic in particular will always message Brown through LeadingReach about any issues with a referral, such as difficulty contacting the patient or a cancellation.

“I’d never done referral management before; but right away, I was impressed with how easy LeadingReach was to use. It intuitively made sense and there was never a struggle with it.”

The Results

Brown cannot imagine having to handle central referral management without LeadingReach. “There’s no doubt LeadingReach increases the volume of referrals we can handle,” says Brown. And she is glad she is not forced to rely on the ‘massive spreadsheet’ she initially anticipated. “Using LeadingReach is so much better than having to track referrals manually.”

LeadingReach has helped CICN’s growth in other ways. For example, CICN has added several out-of-network clinics to their LeadingReach system. Since the CICN clinics send those out- of-network clinics such a high volume of referrals, they use the LeadingReach platform for referral transmission.

Increased visility into referral statuses is another benefit of LeadingReach. “It leaves a nice paper trail – or rather a digital trail – into what’s been done for each referral,” Brown explains.

Brown is also impressed by the reliability of the LeadingReach platform and their support team. “I’ve used other software,” Brown continues, “such as for billing, where every new upgrade makes something break. We don’t ever have that problem with LeadingReach. And I can’t tell you how wonderful the support team is.”

The ease of HIPAA-compliance with LeadingReach is another plus. “I appreciate that LeadingReach eliminates the necessity of sending referrals via email,” says Brown. “Email transmission is not HIPAA-compliant, but many clinics would only accept referrals via email, if LeadingReach were not in place.

That puts CICN in a tough spot. So LeadingReach takes care of that problem.”

Based on CICN’s results, Brown would recommend LeadingReach to anyone handling referral management. “It’s super easy to use and very reliable. The way it works just makes sense.

The whole referral process flows so much more easily. LeadingReach is awesome!”

“I appreciate that LeadingReach eliminates the necessity of sending referrals via email, email transmission is not HIPAA-compliant, but many clinics would only accept referrals via email, if LeadingReach were not in place. That puts CICN in a tough spot. So LeadingReach takes care of that problem.”

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